Healthcare Provider Details

I. General information

NPI: 1720959430
Provider Name (Legal Business Name): JESSICA KEMPKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SANTIAM HWY SE
ALBANY OR
97322-5265
US

IV. Provider business mailing address

2500 SANTIAM HWY SE
ALBANY OR
97322-5265
US

V. Phone/Fax

Practice location:
  • Phone: 541-967-6730
  • Fax:
Mailing address:
  • Phone: 541-967-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0020700
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: